A private hospital worker abused an elderly woman, leaving her with bruising and unable to walk after the attack, an investigation has found.
The healthcare assistant's assault on the 82-year-old with dementia was outlined in a highly critical report released today by Deputy Health and Disability Commissioner Rose Wall.
The woman, who worked at an unnamed private hospital run by the Auckland-based Christian Healthcare Trust (CHT), caused several injuries in what Ms Wall described as a "very distressing case".
She said the woman - referred to as Mrs A in the report - sustained fingermark bruising to her arms and had a painful knee, which she referred to as being "bashed".
"This is a woman who, until she entered this facility, could walk freely; after the incident, she wasn't able to walk and she had bruising to her left thigh as well."
The deputy commissioner's report found the assistant, described as Ms C, had grabbed the woman's upper arms and slapped her thigh, causing it to become swollen and shiny.
Police later charged her with assault and she pleaded guilty when she appeared in court earlier this year.
The woman's family described discovering bruising on her head, behind her neck and on two fingers, as well as a swollen knee.
Ms Wall's report outlined an interview the trust held with another healthcare assistant, who said Ms C had grabbed Mrs A by the arms and taken her back to her room.
The assistant said she heard the woman shout "leave me alone" and heard a bang. She then heard the patient screaming and shouting "leave me alone, it hurts, it's sore, don't punch me".
The CHT conducted an internal investigation and decided the worker had not wilfully intended to abuse the woman, and she was given a written warning.
The trust said she had "received the relevant training and knew what to do... the key issue that was identified... at the time was Ms C's issues with patient intimacy and sexuality".
It provided her with training in that area, but Ms Wall said the training did not address issues concerned with abuse and neglect.
Following the internal investigation, Ms C was dismissed from her job for serious misconduct and a CHT manager contacted the police.
The trust told Ms Wall there had been a previous allegation of physical abuse by the healthcare worker towards a resident in the hospital's dementia unit, in 2013.
Mrs A's granddaughter said in the report she found her grandmother crying uncontrollably on day nine of her stay and she "begged me to get her out of there". The granddaughter said they decided to discharge her and take her to a public hospital to have her injuries checked out.
She said, after her grandmother was discharged from the public hospital, she took her back to her house.
The granddaughter said her grandmother was afraid and had sleeples nights and, after three days of attempting to rebuild her confidence and reassure her she was not going back to the hospital, her grandmother suffered a stroke.
"This has been a very horrific ordeal for all of us, and very traumatising for my poor grandmother", she said.
Her grandmother died three months later in early 2014.
The case has been referred to the Health and Disability Commissioner's Director of Proceedings - an independent legal arm - who will decide whether to take a legal case against the healthcare worker.
CHT chief executive Max Robins would not be interviewed but said in a statement:
'On behalf of the CHT, an independent healthcare trust, we are sorry for the stressful situation Mrs A's family has experienced as a result of the incident."
However, he did defend the trust's actions: "We are steadfast in our confidence that the CHT team moved with a high degree of pace to take all the necessary steps and processes to manage this situation for Mrs A, her family and our staff member involved, both at the time of the incident and afterwards.
"As an organisation, we were disappointed with the findings of the inquiry, given the very good record we have over our 53-year history of providing great care for older people."